Edward C. Green

Edward C. (Ted) Green is an American medical anthropologist who was a Senior Research Scientist at the Harvard School of Public Health[1] and served as director of the AIDS Prevention Project at the Harvard Center for Population and Development Studies. He was later affiliated with the Dept. of Population and Reproductive Health at The Johns Hopkins University (2011-14.) He was appointed to serve as a member of the Presidential Advisory Council on HIV/AIDS (2003–2007),[2] served on the Office of AIDS Research Advisory Council for the National Institutes of Health (2003–2006), and serves on the board of AIDS.org[3] and the Bonobo Conservation Initiative.[4] He has worked for over 30 years in international development.[5] Much of his work since the latter 1980s has been in AIDS and sexually transmitted diseases, primarily in Africa, but also in Asia, Latin America, the Caribbean, the Middle East and Eastern Europe. He served as a public health advisor to the governments of both Mozambique and Swaziland. He was widely quoted in March 2009 when he publicly agreed with Pope Benedict XVI's claim that the distribution of condoms was not helping and might even be aggravating the problem of AIDS in southern and east Africa.

For his dissertation ethnographic research in the early 1970s, Green spent two years living with the Matawai Maroons of Suriname, descendants of escaped African slaves who have lived in the Amazon rain forest for over two centuries.

Green is a pioneer in anthropological research on indigenous healers and in developing public health programs that involve collaboration between African indigenous healers and biomedical personnel. He has guided such programs in Mozambique, Swaziland, South Africa and Nigeria. He has published extensively on indigenous African healing roles and behaviors, as well as underlying health-related knowledge and beliefs, and has written the following 3 books on these topics: Practicing Development Anthropology(1986), AIDS And STDs in Africa: Bridging the Gap Between Traditional Healing and Modern Medicine (1994), Indigenous Theories of Contagious Disease (1999). Regarding the last, Prof. Charles Good wrote in Ethnology and reprinted on Amazon.com, "Green ranks among the foremost practitioners of applied medical anthropology who work in developing societies. His focused contract work and extensive published scholarship reflect a strong commitment to separating myth from reality in public health and medical pluralism."

In Rethinking AIDS Prevention: Learning from Successes in Developing Countries (2003), Green challenged the accepted wisdom of the AIDS prevention community about the efficacy of condoms and HIV counseling and testing as prevention strategies. He argued that epidemiological evidence showed it was declines in number (and perhaps concurrency) of sexual partners that was primarily responsible for Uganda's two-thirds decline in HIV prevalence from 1992 to 2003, and also noted evidence of changes in sexual behavior and HIV prevention success in other countries. Green summarises the book's thesis as follows: "The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs--stressing increased monogamy and delayed sexual activity for young people--have made the greatest headway in fighting or preventing the disease's spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results."

A review of Rethinking AIDS Prevention in the Journal of the American Medical Association stated: "If Green’s analysis is correct, we are faced with a troubling paradox: while our technologically sophisticated system often operates at the margin of acceptable cost efficacy, halfway around the world, secular bias and biomedical fiscal power are responsible for discouraging and discrediting simple yet effective solutions, at the cost of millions of lives."[7]

In March 2009, Green generated controversy when he supported a remark from Pope Benedict XVI about the role of condom promotion in Africa. In a mid-flight news conference en route to Cameroon, Pope Benedict had said: "If the soul is lacking, if Africans do not help one another, the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem."[8][9]

Green responded with a March 29, 2009 editorial in The Washington Post ("The Pope May Be Right").[10] In this editorial he argued that empirical data supported the Pope, and that condoms have not worked as a primary HIV-prevention measure in Africa. Green argued that the tendency of people in steady relationships to not use condoms, and the "risk compensation" phenomenon ("if somebody is using a certain technology to reduce risk, a phenomenon actually occurs where people are willing to take on greater risk"), may account for the failure of condoms to reduce HIV infections in Africa. (Articles in the prestigious medical journals British Medical Journal and The Lancet, by Cassell et al. (2006)[11] and Richens et al. (2000)[12] have discussed the potential for condom use to lead to risk compensation or behavioral disinhibition.) Green concludes, "So what has worked in Africa? Strategies that break up... sexual networks -- or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones."

Green also gave an extended interview with the BBC Northern Ireland on March 29, 2009 to explain his response to the Pope's statement.[13] In this interview, he stated that while there was no proof of a causal connection between condom usage and a decrease or increase in HIV prevalence at the population level, some evidence supported an association between condom distribution and riskier sexual behavior. He cited a study published in the journal JAIDS which "followed two groups of young people in Uganda, and the group that had the intensive condom promotion actually was found to have a greater number of sex partners.[14] So that cancels out the risk reduction that the technology of condoms ought to provide."

Green also stated, "the distribution and marketing of condoms is not the solution or the best solution to African AIDS."[13] When questioned on his belief that condom promotion should be a backup strategy, he answered, "they should have a back-up role even in the generalised epidemics of Africa. I believe condoms should be made available to everyone. It should be, as you say, the ABC strategy: Abstinence, be faithful, use a condom."[13]

During the same interview, he stated that his Harvard research project was ending. When asked if Harvard had ended the project because of his "politically incorrect" views on the failure of condom distribution programs in Africa, Green replied: "My position is very politically incorrect. I have always been politically incorrect. I have always questioned authority and tried to speak truth to power whatever the consequences... I don't know whether our programme would have ended when it's ending if I had been more politically correct. You would have to ask Harvard."[13] The administrator of Green's Harvard project later clarified in a statement posted on the BBC website that the end date of the project was unrelated to Green's statements about the Pope or condoms in Africa. The statement said (in part): "The research grant that Dr. Green runs through Harvard University had a 3 year term which would have ended on February 28, 2009. Harvard University and the funder agreed to an extension for an additional year... So I can verify that in no way has Harvard University ended the project."[15]

Green updated his argument that sexual behavior needs to be addressed in AIDS prevention in two later books: Broken Promises: How the AIDS Establishment Has Betrayed the Developing World, and, with Allison Herling Ruark, AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention, both published in 2011. On the back cover of the latter book, Africanist scholar Prof. John Janzen wrote "(this book) should be on every Africanist medical anthropology reading list."

Upon the conclusion of the Harvard AIDS Prevention Research Project grant in April 2010, Dr. Green established the New Paradigm Fund [5] to identify, develop and share superior models for addressing the problems associated with AIDS, addiction, rain forest and primate conservation, and aspects of poverty associated with stateless and minority peoples. The New Paradigm Fund collaborated with the Ubuntu Institute [6] working toward the prevention of HIV/AIDS, empowerment of women, eradication of poverty and providing access to education in Africa through the use of African cultural values, heritage and indigenous knowledge systems.

Green, E.C., Testimony, “HIV prevention: How Effective is PEPFAR?” House Government Reform Subcommittee on National Security, Emerging Threats, and International Relations, U.S. House of Representatives, Sept. 6, 2006.

Green, E.C., Testimony, Fighting AIDS in Uganda: What Went Right? Hearing before the Subcommittee on African Affairs of the Committee on Foreign Relations, United States Senate, One Hundred Eighth Congress, first session, May 19, 2003 (pp.36-40, also co-author of pp. 15-23) http://www.access.gpo.gov/congress/senate.

Guitarist in rock band in the 1960s in Seoul, Korea (The Silvertones) and fiddler and multi-instrumentalist in Appalachian string bands in the 1970s (Sweetwater String Band, Washington, DC. and the Wild Turkey String Band, Morgantown, WV)